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The effect of microvascular decompression for hemifacial spasm caused by vertebrobasilar dolichoectasia

Authors
 장진우 
Citation
 Journal of Korean Neurosurgical Society, Vol.52(2) : 85~91, 2012 
Journal Title
 Journal of Korean Neurosurgical Society 
ISSN
 2005-3711 
Issue Date
2012
Abstract
OBJECTIVE: Hemifacial spasm (HFS) caused by vertebrobasilar dolichoectasia (VBD) is very rare, and in theses cases, it is difficult to decompress the nerve from its vascular compression. The objective of this study was to investigate the outcome of microvascular decompression (MVD) for HFS caused by VBD. METHODS: There were 10 patients of HFS caused by VBD at our hospital between September 1978 and September 2008. We evaluated magnetic resonance angiography (MRA) and time of flight magnetic resonance imaginge (TOF MRI) findings using the criteria for VBD. We compared the clinical outcomes of MVD for the 10 patients with VBD with the overall outcomes of the total 2058 MVDs performed for HFS. RESULTS: The results of MVD for HFS caused by VBD were successful in 90.9% of cases. The postoperative complication rate in VBD was 45.5%. Offending vessels in patients with VBD were identified visually during surgery. Adverse effects after MVD were found in 4 patients. We found that the diameter of VBD was significantly greater in patients with complications than in those with no complications (p=0.028). CONCLUSION: Our data shows that MVD may be a good treatment modality for HFS caused by VBD but care must be taken to avoid adverse effects from the procedure. It is important to detach the dolichoectatic artery from its surrounding structures sufficiently to allow it to be easily movable. In addition, attempts should be made to lessen the retraction of the cerebellum during release of the dolichoectatic artery.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/90928
DOI
10.3340/jkns.2012.52.2.85
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Neurosurgery
Yonsei Authors
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